NPIMap

Individual provider Active NPI

Lawrence Bruce Greenberg, M.D.

  • Family Medicine Physician
  • San Pedro, CA
National Provider Identifier
1043348436
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G058769 Issued in CA
Practice address
1499 W 1St St
San Pedro, CA 90732-3255
Phone
(310) 831-9482
Fax
(310) 831-1230
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X G058769 CA
Family Medicine Physician 207Q00000X G058769 CA Primary

Addresses

Primary practice location

1499 W 1St St
San Pedro, CA 90732-3255

Mailing address

1499 W. 1St Street
San Pedro, CA 90732
Phone (310) 831-9482

Other names 1

  • Bruce Greenberg Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgreenberg196660@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000793 CA Practitioner - Family PracticePractitioner - Hospice/Palliative Care 6507967569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
Temple University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Glendale, CA 91202

1499 W 1St St
San Pedro, CA 90732-3255
Phone (310) 831-9482

21501 Avalon Blvd
Suite 100
Carson, CA 90745-2210
Phone (310) 835-6627

Hospital & facility affiliations

  • High Quality Home Health Agency, Inc Home health agency, Torrance, CA, CCN 058346
  • Providence Home Health la County South Home health agency, Torrance, CA, CCN 557447
  • 5 Star Hospice Hospice, Glendale, CA, CCN B31682
  • Blue Shield Hospice Hospice, Glendale, CA, CCN B31723
  • Lifetime Hospice Care, Inc. Hospice, Glendale, CA, CCN B21608
  • Allpeace Care Hospice, Torrance, CA, CCN B21768
  • A1Kare Hospice & Palliative Care, Inc Hospice, Northridge, CA, CCN A11641
  • Providence Little Co of Mary Med Ctr San Pedro Hospital, San Pedro, CA, CCN 050078
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G058769CAMDFamily Medicine Physician
G32040CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Family Medicine CurrentSince Jan 19, 2021 Accepting new patients
Providence Medical Institute Family Medicine Current Accepting new patients
Providence Medical Institute Family Medicine CurrentSince Jan 19, 2021 Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

1499 W 1st St
San Pedro, CA 90732
Phone (310) 241-2590

1430 W 6th St
San Pedro, CA 90732
Phone (310) 832-6431

20911 Earl St
Ste 400
Torrance, CA 90503
Phone (310) 370-0007

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

3475 Torrance Blvd
Ste A
Torrance, CA 90503
Phone (310) 370-3568

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Allpeace CareTorrance, CA, CCN B21768 Hospice Contracted Managing Employee Feb 2, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1043348436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 W. 1ST STREET",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-831-9482",
            "fax_number": "310-831-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 W 1ST ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323255",
            "telephone_number": "310-831-9482",
            "fax_number": "310-831-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "LAWRENCE",
        "middle_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "G058769",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G058769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgreenberg196660@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1499 W 1st St",
            "city": "San Pedro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907323255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRUCE",
            "last_name": "GREENBERG",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.